Local experience with radiosurgery for vestibular schwannomas and recommendations for management

Wong, Ru Xin; Low, Hui Ying Terese; Tan, Daniel

doi:10.11622/smedj.2018107

Cited by 8 publications

(3 citation statements)

References 42 publications

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“…The other focused on diet, exercise and other lifestyle modifications for the past few years, during which a durably stable lesion was seen on repeat imaging with no progression of symptoms. Wong et al (3) described in detail their single-institution series of 77 VSs treated with radiosurgery and provided a concise, comprehensive review of the management of VS. Publishing treatment outcomes of uncommon diseases is a useful contribution to the cumulative global body of literature.…”

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confidence: 99%

The empowerment of all modalities against cancer

Han

Toh

2018

smedj

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confidence: 99%

The empowerment of all modalities against cancer

Han

Toh

2018

smedj

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“…of patients Total dose No. of fractions Median tumor volume cm 3 (min-max) Median follow-up (months) Local control Song 24 31 25 5 1.1 (0.1-8.74) NA 100.00% Williams 25 131 25 5 1.5 (0.05-8.8) 23 100.00% Meijer 7 80 20 (n = 12) 25 (n = 68) 5 2.5 35 94%/5 y Anderson 22 37 20 5 0.89 43.1 90.5%/5 y Wong 26 31 25 5 3.12 40.6 97.00% Kapoor 27 376 25 (n = 340) 30 (n = 36) 5 10 0.89 (0.01-26.30) 56 97.00% Karam 28 37 25 (n = 35) 21 (n = 2) 5 3 1.03 (0.14-7.60) 51 91%/3 y Patel 29 383 25 5 NA 72 97.70% Our study 29 25 5 1.47 (0.56-4.13) 48 96.30% Abbreviation: HSRT = hypofractionated stereotactic radiation therapy. …”

Section: Discussionmentioning

confidence: 99%

Vestibular Schwannoma: Results of Hypofractionated Stereotactic Radiation Therapy

Pialat¹,

Fieux²,

Tringali³

et al. 2021

Advances in Radiation Oncology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…They account for 8% of all intracranial tumors and 80% of cerebellopontine angle tumors [1]. Treatment options include microsurgery, fractionated stereotactic radiotherapy, stereotactic radiosurgery, and a combination of surgery and radiotherapy or observation [2]. The goals of VS management have shifted from surgical excision to functional preservation, particularly when the removal of the tumor is not considered safe in terms of cranial nerve preservation [3-4].…”

Section: Introductionmentioning

confidence: 99%

Preservation of Hearing and Facial Nerve Function with the Microsurgical Excision of Large Vestibular Schwannomas: Experience with the Retrosigmoid Approach

Rajput

Ahmad

Arain

et al. 2018

Cureus

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IntroductionVestibular schwannomas (VS) are the most common benign neoplasms of a cerebellopontine angle (CPA), which arise from the Schwann cells of the vestibulocochlear nerve. Eighty percent of CPA tumors are VS followed by meningioma as the second common mass lesion in this critical potential space. Treatment options range from watchful waiting with serial imaging studies to radiosurgery or a microsurgical excision or a combination of surgery and radiation therapy. The primary objective of the study was to assess hearing and facial nerve status before and after the surgery via the retrosigmoid approach.MethodsThe database of Aga Khan University Hospital was searched for diagnoses of vestibular schwannomas between 2000 and 2007. A total of 35 patients were identified; among them, 27 were selected for the study who met the inclusion criteria. The variables of the study were age, gender, presenting symptoms, size of the tumor, surgical approach, hearing levels, and facial nerve function. Hearing loss was categorized according to the Gardener-Robertson hearing classification and the House-Brackmann Scale was used for facial nerve assessment.ResultsOut of the 27 patients, 18 were male and nine were female. The mean age was 43 years. The most common presenting complaint was hearing loss and tinnitus, seen in 21 patients. Headache was present in six patients, ataxia in five, and vertigo in three. Facial nerve weakness was noticed in six patients. Two patients had Grade-III paralysis, three had Grade-IV paralysis, and one had Grade-V paralysis. The audiogram confirmed the presence of sensorineural hearing loss (SNHL) in all patients. Twelve patients out of 27 had Class II hearing with the threshold between 31 and 50 decibels and a Speech Discrimination Score (SDS) of 50% to 69%. Ten patients had non-serviceable hearing and the remaining five had poor hearing. The audiogram was repeated after surgery for those 12 patients who had Class II hearing and showed that seven out of 12 patients maintained a hearing threshold within the range of Class II at the one-year follow-up (hearing preservation 58%). The facial nerve preservation rate was 56% considering House-Brackmann Grade III or less as acceptable facial nerve function.ConclusionThe optimal treatment for small vestibular schwannomas is a matter of controversy; however, the choice of treatment for large vestibular schwannomas in patients without significant comorbidity is generally microsurgical excision. The surgical excision of a large VS with the retrosigmoid approach is found to be safe consistently. The hearing and facial nerve preservation in our study were found comparable with the literature.

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Local experience with radiosurgery for vestibular schwannomas and recommendations for management

Abstract: Radiosurgery is effective and safe for small VSs or as an adjunct therapy after microsurgery.

Cited by 8 publications

References 42 publications

The empowerment of all modalities against cancer

The empowerment of all modalities against cancer

Vestibular Schwannoma: Results of Hypofractionated Stereotactic Radiation Therapy

Preservation of Hearing and Facial Nerve Function with the Microsurgical Excision of Large Vestibular Schwannomas: Experience with the Retrosigmoid Approach

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